Merging Clinical Social Work Practice and Antiracist Positioning

Contents

1. Introduction
   Wendy Ashley
2. Part I Why Antiracist , Critical Clinical Practice?
3. 1. Antiracist Social Work Education: Pedagogical Congruency in Racial Justice Teaching and Learning
   L. O. Curiel
4. 2. The Impact of Racism and Racial Gaslighting on Practice
   J. Hattley
5. Part II Engagement
6. 3. Resilience-Building Skills to Enhance Anti-Oppressive Social Work Learning
   A. Farina, S. Azhar, & M. Cristofalo
7. Part III Risk Assessment
8. 4. Antiracist and Intersectional Identification, Assessment, and Management of Risk Factors in Clinical Practice
   W. Ashley
9. Part IV Assessment
10. 5. Anti-Oppressive, Intersectional Engagement and Assessment
    T. Brooks, J. Gould, & K. Mortimer
11. 6. The Impact of Anti-Black Racism: Perspectives on Assessment of Racial Trauma When Working with Black-Identified Populations
    L. Smith & N. Wofford
12. 7. The Use of Structural Assessment to Bring a Macro Understanding to Micro-level Encounters
    S. Bussey
13. 8. Conducting Culturally Responsive Mental Status Examinations (CR-MSE)
    A. Lipscomb, W. Ashley, L. Curiel, & S. Mountz
14. Part V Treatment Planning
15. 9. Antiracist Treatment Planning
    E. Maloney, M. Parker, & T. Plachta
16. Part VI Intervention: Micro-Practice
17. 10. LGBTQIA+ Affirmative Therapy
    R. Clark Mane & A. Horthy
18. 11. A Clinical Guide for Challenging Contemporary Racism and Inequities in Latinx Communities
    E. Andujo, N. Juarez, & M. Juarez
19. 12. Indigenous Knowledge and Relational Accountability as Antidotes to the Coloniality of Social Work Practice
    J. Paez, K. Aguilar, M. Hernandez, M. Montoya, L. X. Lermanda Del Aguila, & A. Rosales
20. 13. Structural Competency and Antiracist Social Work Practice with Youth and Families: Part One, Individual and Family Treatment
    N. K. Hernández, M. Milliner, K. Garcia, & C. Mounier
21. Part VII Intervention: Mezzo Practice
22. 14. Antiracist Social Work Practice with Youth and Families: Applying Structural Competency to Practice Settings and With Community Partners
    C. Mounier & A. Cortez
23. 15. Conceptualizing and Responding to Racialized Trauma: Racial Justice Considerations for Forming and Facilitating Groups
    C. Schmidt & C. D. Tronnier
24. 16. Embodying Antiracist Practice Through Mindfulness and Intergroup Dialogue
    S. Mountz, A. Lipscomb, & M. Fowler
25. Part VIII Intervention: Macro-Practice
26. 17. Antiracist Research-Informed Practice
    J. Brown & Y. Tejeda
27. 18. Anti-oppressive and Antiracist Strategies in Unified Courts
    S. Banks, S. Walker, & A. G. Perez
28. Part IX Self-Care and Reflexivity
29. 19. Self-Care as Resistance: Rest as a Pedagogical Tool and Critical Race Praxis
    A. Aldana
30. 20. Impact of Settler Colonialism and Racism on Social Work: Considerations and Challenges for a Self-Reflexive Practice
    C. Souza, K. Cespedes, K.-Bundy Fazioli, & R. Bubar
31. Part X Microaggressions
32. 21. Open Letter to Master of Social Work Students on Microaggressions
    K. Chambers & M. Garcia
33. 22. Using Clinical Skills and an Afrocentric Twelve-Step Model to Navigate Microaggressions
    S. L. Brown
34. 23. Navigating Microaggressions and Macroaggressions in Social Work Practice with Black Clients
    M. A. Robinson, D. A. Boamah, B. Nwachuku, S. Jones-Eversley, E. Sterrett-Hong, S. Miller, S. Moore, & A. C. Adedoyin
35. Part XI Ethics and Values
36. 24. Anti-oppressive Social Work Practice: A Social Justice Values Approach
    D. Harris
37. Part XII Trauma and Healing
38. 25. Cultural Starvation
    M. Valetta
39. 26. Trauma and Healing
    T. A. Butler Davis & A. Zielinski
40. 27. Anti-racist Telehealth Policy and Practice: Using Technology to Heal
    J. Johnson
41. Part XIII Professional Growth and Development
42. 28. Saviorism and Burnout
    M. Salas
43. 29. Unlearning as Praxis: A Love Letter to our MSW Student Selves
    N. Vazquez & S. V. Parras
44. Notes on Contributors

Introduction

Wendy Ashley

It is 2024 and I have been a social work practitioner for over 29 years and a social work educator for just under 20 years. It is apparent that the field and the discipline of social work is in need of a radical transformation. The 2020 viral and racial pandemic created a new context for social work, highlighting ongoing disproportionalities and disparities that were reflected in the number of COVID-19 cases among Black and brown communities and demonstrated by the profiling, murder and criminalization of Black men and women by law enforcement. These dynamics have clarified the need to educate students on practice with contemporary, culturally relevant topics, including antiracist mental health, a critical analysis of power and privilege, White supremacy, intersectional social work, racialized trauma and healing, anti-Blackness, telehealth, microaggressions and utilizing a cultural humility lens.

In the current post-pandemic context, I believe that police brutality, COVID, and racial inequities are unrelenting systemic forces that must be strategically attacked, deconstructed, and dismantled. It is a long game, and social workers are increasingly fatigued, emotionally battered, and burned out. We need new approaches to micro, mezzo and macro work, to educating students, and to effectively manage the despair, powerlessness and hopelessness that comes from the inability to imagine or hope for an equitable, just world.

The Council on Social Work Education (CSWE) released a revised set of competencies for social work education programs in 2022, highlighting the importance of advancing human rights and social, racial, economic, and environmental justice (competency 2) and advancing anti-racism, equity, diversity and inclusion in practice (competency 3). The 2022 EPAS made a shift critical to the field of social work—moving from the banal language of difference ←xi | xii→and diversity to an intentional, conscious emphasis on the role of race and racism in social injustice. Additionally, naming anti-racism, equity and inclusion fundamentally influences how we understand and navigate oppression, trauma, and healing.

In 2021, the National Association of Social Workers (NASW) revised the Code of Ethics to include the importance of self-care for competent and ethical social work practice. The updated Code of Ethics identified the inherent challenges of social work practice, including stressful workplace contexts, professional demands, and exposure to trauma as potential barriers to personal and professional health, well-being, safety and integrity. For the first time, the social, emotional, and environmental risks that have been considered implicit job hazards are named, and organizations are charged with promoting policies, practices, resources, and strategies to support social workers’ self-care. This shift is monumental in that it acknowledges the mental, emotional, and spiritual toll of social work practice, but also creates accountability in agencies, organizations, and educational institutions to deliberately contribute to the wellness of social work practitioners.

While CSWE and the NASW have made some vital modifications in their positionality regarding racism, antiracism and self-care, this is only the first step. In my efforts to provide best practices for the clients I serve, the students I educate, the interns I supervise, the organizations I consult with, and the social work professionals I train, I have yet to find a textbook that addresses the many questions I continue to ask, that I believe are on the forefront of social work practice. I wonder: What does it mean to be a clinical practitioner in 2024 and beyond? Can social workers be BOTH solid clinicians and antiracist practitioners? How do we implement and integrate antiracist , critical conscious, intersectional skills with clinical skills? What does social work practice—that includes white supremacy, anti-Blackness and oppression language and concepts—look like? How do we center nondominant perspectives, voices and approaches in an educational context that is inherently dominant? I set out to write a book I could use in my classes that, rather than simply answer the hard questions, initiates difficult discourse and uncomfortable conversations about what antiracist, trauma-informed, clinically sound best practices may be, and how to facilitate them.

I am a Black, biracial, cisgender, heterosexual, light-skinned woman. I identify as a social worker, a mom, a wife, and a friend. I have a Doctorate in Clinical Psychology, a Master of Social Work degree and a bachelor’s degree in psychology. I am a Licensed Clinical Social Worker, and I am certified in Eye Movement Desensitization and Reprocessing (EMDR) and in Diversity and Inclusion Practices from Cornell University’s School of Industrial and Labor ←xii | xiii→Relations. My professional identities include Professor, clinician, workshop training facilitator, organizational climate trainer and consultant, published author, and keynote speaker. Despite almost 30 years of expertise and credibility in the field, I consistently battle perfectionism and imposter syndrome. I must consistently redefine how I view my own intersectional identities in relation to how I am viewed under a dominant, white gaze. And yet I persist.

This textbook is an effort to combine all of who I am with what has been missing in the field for as long as I can remember. My hopes for this book are incrementally larger than the scope of a textbook: I want to decrease disproportionality, disparities, underrepresentation and invisibility in treatment settings; combat stigma, decrease shame in help seeking, promote cultural humility, authenticity, transparency and vulnerability; make therapy spaces more accessible, more humane and more effective; encourage what is in therapy spaces to be examined, unpacked and dismantled, rather than simplified, ignored or minimized; and deconstruct what it means to be a social worker, a therapist, a clinician, a practitioner, and an educator. Ultimately, the primary aim of this book is to do what the title suggests: To merge solid, clinical practice with antiracist positioning.

This book is structured based on a blend of key social work competencies with an anti-oppressive, antiracist , trauma-informed, clinical approach. Current available social work practice textbooks range from clinically oriented, and theory-based to social justice focused. What is missing and what this book contributes is a text that provides information and knowledge on what effective, anti-oppressive, clinical practice is and skills to facilitate this type of service provision. Each chapter will provide basic knowledge about the topic, followed by reflective questions and exercises for critical analysis, case examples for practice and tools for implementing these skill sets. Combining these topics is both timely and progressive. Social workers not only need to understand clinical theory and practice skills but also learn skills to navigate engagement, assessment, treatment planning, and intervention with clients, families, and communities who have historical trauma, experiences with systemic oppression, medical and mental health distrust, and multiple intersectional identities. Learning how to increase practitioner self-awareness, engage in strategic action, and improve individual and collective accountability are the beginnings of an antiracist clinical practice.

Safe travels, social work colleagues. Sending you love and light as you begin what will be a lifelong journey. I hope this book is a helpful companion.